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PerCEN: A cluster randomized controlled trial of person-centered residential care and environment for people with dementia

Authors

Chenoweth, Lynn, Forbes, Ian, Fleming, Richard, King, Madeleine T., Stein-Parbury, Jane, Luscombe, Georgina, Kenny, Patricia, Jeon, Yun-Hee, Haas, Marion, Brodaty, Henry

Journal

International Psychogeriatrics, Volume: 26, No.: 7, Pages.: 1147-1160

Year of Publication

2014

Abstract

Background: There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE. Methods: 38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified, then randomized to one of four intervention groups: (1) PCC; (2) PCE; (3) PCC + PCE; (4) no intervention. People with dementia, over 60 years of age and consented were eligible. Co-outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation, emotional responses in care, quality of life and depression, and care interaction quality. Results: From 38 homes randomized, 601 people with dementia were recruited. At follow-up the mean change for quality of life and agitation was significantly different for PCE (p = 0.02, p = 0.05, respectively) and PCC (p = 0.0003, p = 0.002 respectively), compared with the non-intervention group (p = 0.48, p = 0.93 respectively). Quality of life improved non-significantly for PCC + PCE (p = 0.08), but not for agitation (p = 0.37). Improvements in care interaction quality (p = 0.006) and in emotional responses to care (p = 0.01) in PCC + PCE were not observed in the other groups. Depression scores did not change in any of the groups. Intervention compliance for PCC was 59%, for PCE 54% and for PCC + PCE 66%. Conclusion: The hypothesis that PCC + PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)

Bibtex Citation

@article{Chenoweth_2014, doi = {10.1017/s1041610214000398}, url = {http://dx.doi.org/10.1017/s1041610214000398}, year = 2014, month = {mar}, publisher = {Cambridge University Press ({CUP})}, volume = {26}, number = {07}, pages = {1147--1160}, author = {Lynn Chenoweth and Ian Forbes and Richard Fleming and Madeleine T. King and Jane Stein-Parbury and Georgina Luscombe and Patricia Kenny and Yun-Hee Jeon and Marion Haas and Henry Brodaty}, title = {{PerCEN}: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia}, journal = {Int. Psychogeriatr.} }

Keywords

agitation, care, centred, dementia, environment, intervention, person, residential care, residential care institutions

Countries of Study

Australia

Types of Dementia

Dementia (general / unspecified)

Types of Study

Cluster RCT

Type of Outcomes

Behaviour, Depression and Anxiety, Quality of Life of Person With Dementia

Settings

Long Term Residential Care without medically trained staff

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Other